New Medication for High-Risk Populations Could Reduce the Health and Economic Burden of Heart Disease

Ottawa, April 27, 2017—Heart disease is the leading cause of death among Canadians and is one of the main reasons for hospitalizations and disability in Canada. Cardiovascular disease prevalence and mortality represent significant costs to public governments and society due to hospitalizations, disease management, and lost productivity in Canada.

A new report from The Conference Board of Canada estimates that increasing access to a new medication category to help manage high cholesterol in high-risk patients could avert hundreds of thousands of deaths due to heart disease and save up to $34.8 billion for the Canadian health care system and economy over the next 20 years.

“Heart disease is preventable for many people through changing, eliminating or avoiding one or several risk factors, such as hypertension, smoking, diabetes, obesity, and high cholesterol,” said Isabelle Gagnon-Arpin, Senior Research Associate in health economics, The Conference Board of Canada. “Improving access to effective cholesterol lowering treatment for high-risk individuals could help reduce the health and economic burden of heart disease in Canada.”

Highlights

Cardiovascular disease prevalence and mortality represent significant costs to public governments and society due to hospitalizations, disease management and lost productivity in Canada.

Improving access to effective cholesterol lowering treatment for high-risk individuals could avert close to 215,000 fatal cases of cardiovascular disease by 2035.

Direct and indirect cost savings to the Canadian health care system could total up to $34.8 billion over the next 20 years.

The health care costs for cardiovascular diseases totaled $22.2 billion in 2000. The largest contributor to health care costs were hospitalizations ($4.0 billion), followed by drug costs ($2.1 billion) and physician costs ($1.5 billion). Indirect costs resulted largely from lost productivity ($9.3 billion), as well as short- and long-term disability ($5.4 billion).

The report, Reducing the Burden of Cardiovascular Diseases in Canada, assesses the impact of increasing access to PCSK9 inhibitors to manage LDL-cholesterol (LDL-C) in two populations at high-risk of cardiovascular disease. The first population includes individuals with heterozygous familial hypercholesterolemia (HeFH), a genetic disorder characterized by high LDL-C levels leading to premature CVD. The second population features secondary prevention patients, which includes individuals who have already experienced a cardiovascular event, such as a heart attack or stroke.

Between 0.2 per cent and 0.4 per cent of Canadian adults are believed to have HeFH. In 2016, this represented between 56,649 and 113,298 adults ages 20 years or over. Increasing access to PSCK9i for the HeFH population with LCL-C levels not at target could lead to between 980 and 36,618 averted CVD cases by 2035. The cumulative number of averted fatal cases ranged from 324 to 12,084 over the next 20 years, while total cost savings, including direct costs to the Canadian health care system and indirect costs from lost productivity due to premature mortality and hospitalizations, ranged from $52.3 million to $2.0 billion.

With regards to secondary prevention, around 6 per cent of Canadian adults are currently living with cardiovascular disease. In 2016, this represented between 1.7 million adults ages 20 years or over. Increasing access to PSCK9i for the secondary prevention population with LCL-C levels not at target could lead to 614,208 averted CVD cases between 2016-2035, and between 67,901 to 202,689 averted fatal events. Total cost savings ranged from $11.0 billion to $32.8 billion over the next 20 years.

This study does not factor in the cost of treatment with PCSK9i, which is estimated at around $7,300 per patient per year in Canada. While applying the cost of treatment would reduce some of the estimated direct cost savings, the cumulative savings would remain significant.

The report was made possible through financial support of Amgen Canada. Repatha® data was used as a reference to illustrate the value of the PCSK9 class of drugs.